TMJ 'dysfunction' - Health implications

Research: beta-interferon & progression
Posted: 12 Nov 2012 05:00 PM PST
Epub: Greenberg BM et al. Interferon Beta Use and Disability Prevention in Relapsing-Remitting Multiple Sclerosis. Arch Neurol. 2012 Nov 5:1-4. doi: 10.1001/jamaneurol.2013.1017.

CONTEXT:  Interferon beta is widely prescribed to treat MS; however, its relationship with disability progression has yet to be established.

OBJECTIVE: To investigate the association between interferon beta exposure and disability progression in MSers with relapsing-remitting MS.

DESIGN, SETTING, AND PATIENTS:  Retrospective cohort study based on prospectively collected data (1985-2008) from British Columbia, Canada. MSers with relapsing-remitting MS treated with interferon beta (n = 868) were compared with untreated contemporary (n = 829) and historical (n = 959) cohorts.

MAIN OUTCOME MEASURES:  The main outcome measure was time from interferon beta treatment eligibility (baseline) to a confirmed and sustained score of 6 (requiring a cane to walk 100 m; confirmed at 150 days with no measurable improvement) on the Expanded Disability Status Scale (EDSS) (range, 0-10, with higher scores indicating higher disability). A multivariable Cox regression model with interferon beta treatment included as a time-varying covariate was used to assess the hazard of disease progression associated with interferon beta treatment. Analyses also included propensity score adjustment to address confounding by indication.

RESULTS:  The median active follow-up times (first to last EDSS measurement) were as follows: for the interferon beta-treated cohort, 5.1 years (interquartile range [IQR], 3.0-7.0 years); for the contemporary control cohort, 4.0 years (IQR, 2.1-6.4 years); and for the historical control cohort, 10.8 years (IQR, 6.3-14.7 years). The observed outcome rates for reaching a sustained EDSS score of 6 were 10.8%, 5.3%, and 23.1% in the 3 cohorts, respectively. After adjustment for potential baseline confounders (sex, age, disease duration, and EDSS score), exposure to interferon beta was not associated with a statistically significant difference in the hazard of reaching an EDSS score of 6 when either the contemporary control cohort (hazard ratio, 1.30; 95% CI, 0.92-1.83; P = .14) or the historical control cohort (hazard ratio, 0.77; 95% CI, 0.58-1.02; P = .07) were considered. Further adjustment for comorbidities and socioeconomic status, where possible, did not change interpretations, and propensity score adjustment did not substantially change the results.

CONCLUSION:  Among MSers with relapsing-remitting MS, administration of interferon beta was not associated with a reduction in progression of disability.

COMMENT: While medical science is continually evolving. The concept of cause and effect in medical science is often more complicated than simply knowing that numbness in legs or optic neuritis is pathognomonic of 'MS'. Many factors interact in complex ways. Treatment methods can sometimes work by interrupting these interactions, reducing their severity, or preventing their occurrence, or providing symptomatic relief with drugs. However, in the case of 'MS' I failed to find any patient where I could not confirm that bodily asymmetries were indeed the root cause of their problems. Instituting the correct physical treatment rapidly brings about resolution. It is simply not possible to change any symptom 'MS' drugs! The cause is not understood, so how can any treatment which is dreamt up work?
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